The role of central nervous system in tendon pain.
Tendinopathy and the associated pain remain even today an enigma for both clinicians and patients. Data from animal studies have shown bilateral tendon changes in response to unilateral exercise. This advocates a potential centrally mediated process relevant to the pathogenesis of tendinopathy. The aim of this study was to review the available evidence for the presence of bilateral motor and sensory changes in patients with tendinopathy.
Twenty articles were included in this review; 17 examined lateral epiconlytis (LE), 1 achilles tendinopathy, 1 patella tendinopathy and 1 rotator cuff tendinopathy. A meta-analysis was performed only in LE studies. The results revealed significant sensory and motor deficits in both the injured and non-injured limb in people with unilateral tendinopathy- specifically LE- as compared to healthy controls.
The findings support the notion that the central nervous system is involved tendinopathy. The clinical implications are very important as it clearly demonstrated that the contralateral side can not be used as a refence for comparison during assessment and treatment strategies should focus also in the unijured limb.
> From: Heales et al., Br J Sports Med 48 (2015) 1400-1406. All rights reserved to BMJ Publishing Group Limited. Click here for the Pubmed summary.